What is the menopause?  

The menopause is a perfectly natural climacteric phase in a woman’s life where she stops ovulating and is no longer fertile. 

It is referred to as “the change of life” and happens to women around the ages of the late 40s and early 50s. There are cases where this phase of life happens at a very young age, though it is not the norm. In either case, whether younger or older, there is no way it can be prevented. You are considered post-menopausal if you have not had a period for a year or more.  

The menopause comes with many symptoms that can last for up to five years, sometimes longer. Not all symptoms are experienced by all women.  

Signs and Symptoms

Symptoms can be mild or severe, and not all women will display all symptoms.   

Symptoms include anxiety, heart palpitations, depression, dizziness, dryness and ageing of the skin, hot flushes (hot flashes in the US), night sweats, breast tenderness, painful intercourse due to vaginal dryness, reduced libido, mood swings, fatigue, and headaches.

Causes

The ovaries stop producing the hormones oestrogen and progesterone, and their lack of presence in the body leads to many changes. Oestrogen keeps the skin smooth and soft and prevents the arteries from getting clogged. 

Post-menopausal women are at a greater risk of developing osteoporosis because oestrogen is necessary for proper bone formation. (See our article on Osteoporosis)

Oestrogen also helps keep the body’s internal temperature-regulation in check. Other organs in the body produce oestrogen so the menopause does not mean that the body does not have any of this hormone at all; it just means the body has smaller amounts.

Complementary Approach

The following information does not constitute a prescription or recommendations – this is included for your information only.

Eat: Cut down on salt as retaining water will only increase your urinary excretion of calcium. There are a variety of salt substitutes on the market. 

Choose a diet that consists of 50% raw foods, including leafy greens, such as broccoli. 

Drink 2 litres of water a day to flush the system and to help keep the skin hydrated. 

Hot flushes are less common in women who live in countries where the diet is high in soya products (1), and trials support this theory (2,3). In Japan, women are reported to have fewer menopausal symptoms, possibly due to their diet. Foods typical to Japanese diet such as tofu, soybeans, and miso contain oestrogen-like compounds, and, therefore, they act like oestrogens in the body. Soya is known to affect a woman’s menstrual cycle (4), and there are reports into the (weak) oestrogenic activity of soy (5).

Avoid eating: Animal products and dairy play a part in the loss of calcium from the bones and also aggravate hot flushes. Yoghurt seems not to cause as many problems, however, as yet scientists are unsure as to quite why this is. 

Sugar is best avoided as it can induce mood swings. Alcohol, spicy foods, soups, and hot drinks should be avoided too as these aggravate hot flushes. 

Nutritional Supplements

The following information does not constitute a prescription or recommended dose – studies have been conducted using the dosages stated and are included for your information only. The nutrients mentioned here are often recommended by Healthcare practitioners.

Vitamin E reduces many symptoms (6,7,8,9) although not all studies reported benefits (10) especially for hot flushes. Take 400 IU daily and slowly increase the dose until hot flushes subside. Do not take more than 1,600 IU daily. 

Multienzyme complex with hydrochloric acid (HCL) aids digestion. Take with meals as directed on the label.

Lecithin granules assist vitamin E, thus reducing hot flushes. Take 1 tablespoon 3 times a day before meals. Or in capsule form, take 1,200 mg 3 times daily. 

Evening primrose oil or black currant seed oil have has sedative properties and are important in the production of oestrogen and good for hot flushes. Take as directed on the label.

Take all B vitamins together as they work better that way. 

Vitamin B5 is commonly known as the anti-stress vitamin. Take 100 mg 3 times daily. 

Vitamin B Complex improves circulation Take as directed on the label.  

Vitamin B6 eases water retention. Take 50 mg 3 times daily.

Herbs

Black cohosh is useful for women who experience hot flushes (11,12). Take 20 mg of highly concentrated extract twice a day. Or, if you are using tincture form, take 2-4 ml 3 times a day. 

The herbs mentioned here have historically been considered beneficial in the treatment of various conditions including menopause. Therefore, healthcare practitioners often recommend them. 

Sage seems to decrease the production of sweat, and is therefore often recommended for women who experience sweat due to hot flushes (13).

Aloe vera gel and slippery elm powder relieve vaginal dryness. Mix these 2 together into a paste that has a consistency similar to toothpaste. This can then be inserted into the vagina at night. 

Damiana has been hailed as an aphrodisiac since ancient times and has been used to treat various sexual disorders. You can make a tea by adding 1 gram of dried leaves to a cup of boiling water. Steep for 10-15 minutes and drink 3 cups per day. To use in tincture form, take 2-3 ml 3 times a day.  In capsule form, take 400-800 mg 3 times daily.  

Damiana is usually used in conjunction with other herbs; however, one of the side effects of damiana is slight diarrhoea.  

Fennel, licorice, unicorn root, wild yam, squawvine, and raspberry are all promoters of oestrogen. Be sure not to use licorice for more than 7 days in a row, and do not use sage if you suffer form any seizure disorders. 

Chamomile and valerian root both help relax the body. If you have trouble sleeping you could consider these herbs. Drink them as teas or take them in capsule for, for the latter, refer to the label for directions.  

Vitamin E oil is a great way to relief an itchy vagina. Snip off the end of a vitamin E capsule and apply. Do also try fragrance free vitamin E cream.

Aloe vera gel can be used as a lubricant when having sexual intercourse if you find you are dry. 

Further Information

If you can develop a healthy attitude to this phase of life, you will find you have an easier time of it. Those who view it as the end of their fertility, and somehow see themselves as less valuable because of it, tend to have a much harder time of it all. 

Meditation and mindful movement, such as yoga, will help de-stress you. 

Studies show that exercise can help decrease the symptoms associated with menopause (13); it is especially helpful in alleviating hot flushes (14,15).

A 2023 controlled study concluded that a twelve-week Qigong exercise programme had beneficial effects on the severity of menopausal symptoms (19).

References

1. Knight DC, Eden JA. A review of the clinical effects of phytoestrogens. Obstet Gynecol 1996;87:897–904 [review].
2. Albertazzi P, Pansini F, Bonaccorsi G, et al. The effect of dietary soy supplementation on hot flushes. Obstet Gynecol 1998;91:6–11.
3. Murkies AL, Lombard C, Strauss BJ, et al. Dietary flour supplementation decreases post-menopausal hot flushes: Effect of soy and wheat. Maturitas 1995;21:189–95.
4. Cassidy A, Bingham S, Setchell KDR. Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr1994;60:333–40.
5. Baird DD, Umbach DM, Landsedell L, et al. Dietary intervention study to assess estrogenicity of dietary soy among postmenopausal women. J Clin Endocrinol Metab1995;80:1685–90. 
6. Perloff WH. Treatment of the menopause. Am J Obstet Gynecol 1949;58:684–94.
7. Gozan HA. The use of vitamin E in treatment of the menopause. NY State J Med 1952;52:1289.
8. Christy CJ. Vitamin E in menopause: Preliminary report of experimental and clinical study. Am J Obstet Gynecol 1945:50:84.
9. Finkler RS. The effect of vitamin E in the menopause. J Clin Endocrinol Metab 1949;9:89–94.
10. Rubenstein BB. Vitamin E diminishes the vasomotor symptoms of menopause. Fed Proc 1948;7:106 [abstr].
11. Blatt MHG et al. Vitamin E and climacteric syndrome: Failure of effective control as measured by menopausal index. Arch Intern Med 1953;91:792–99.
12. Duker EM. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med 1991;57:420–24.
13. Lieberman S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause. J Womens Health 1998;7:525–29.
14. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 420–21[review]. 
15. Slaven L, Lee C. Mood and symptom reporting among middle-aged women: The relationship between menopausal status, hormone replacement therapy, and exercise participation. Health Psychol 1997;16:203–8.

16. Ivarsson T, Spetz AC, Hammar M. Physical exercise and vasomotor symptoms in postmenopausal women. Mauritas 1998;29:139–46
17. Hammar M, Berg G, Lindgren R. Does physical exercise influence the frequency of postmenopausal hot flushes? Acta Obstet Gynecol Scand 1990;69:409–12.6.

18. Brezinski A, Adlercreutz H, Shaoul R, et al. Short-term effects of phytoestrogen-rich diet on postmenopausal women. Menopause 1997;4:89–94

19. Carcelén-Fraile MDC, Hita-Contreras F, Martínez-Amat A, Loureiro VB, Loureiro NEM, Jiménez-García JD, Fábrega-Cuadros R, Aibar-Almazán A. Impact of Qigong exercises on the severity of the menopausal symptoms and health-related quality of life: A randomised controlled trial. Eur J Sport Sci. 2023 Apr;23(4):656-664. doi: 10.1080/17461391.2022.2044915. Epub 2022 Mar 7. PMID: 35179431 [abstract].